Associations Between the Subtypes of Aggression, Parenting Styles and Psychiatric Symptomatology in Children on a Psychiatric Inpatient Unit

Childhood aggression often precedes more costly problem behavior that may result in psychiatric hospitalization. However, aggression is not a unidimensional construct, as there are subdimensions of aggression. A common way that aggression is divided is by the motivation behind the behavior, namely proactive and reactive aggression. Proactive aggression is calculated in nature, whereas reactive aggression occurs in response to a perceived threat. Some evidence suggests differential outcomes for these aggression subtypes; thus, further understanding of the link between the subtypes of aggression and psychiatric problems may help to refine current prevention efforts and reduce the number of hospitalizations.

Consistent with a developmental-ecological perspective, which posits that multiple factors play a role in the development of problem behavior, the current study examined the link between the subtypes of aggression and internalizing and externalizing symptomatology, as well as examined parenting behavior, gender, age, and race as potential moderators of these relations. Participants were 392 children ages 6-12 years of age (M = 9.4, SD = 1.9) admitted consecutively to a psychiatric inpatient facility for both internalizing and externalizing symptomatology. Results indicated that both proactive and reactive aggression were associated with externalizing problems. Reactive aggression was associated with both anxiety and affective symptoms, but not somatic problems for particular individuals. Proactive aggression was associated with internalizing problems when specific parenting styles and demographic factors were present. Although both proactive and reactive aggression were associated with both internalizing and externalizing symptoms, differential associations were evident. Further, the impact of parenting styles on these associations were dependent upon gender, age and/or race.